Hello from Clear Solutions co-founders Charlie and Martyn!
We’re excited to share with you the results of our ORS and Zinc community distribution pilot in Kano, Nigeria. We give a quick overview below, with many more details in the full report. There are important caveats, but our takeaway is that the intervention led to a meaningful increase in ORSZ usage and we should take it forward with further operational improvements.
Pilot recap
Between Dec’23 and Feb’24, we ran a pilot distribution of oral rehydration solution and zinc (ORSZ), low-cost and highly effective treatments for diarrhoea. We completed this in Kano, Nigeria, with our implementation partner iDevPro Africa.
Community Health Workers (CHWs) distributed ORSZ ‘co-packs’ to ~6900 children under-5 across 20 communities. During the visits, caregivers (mostly mothers) were advised on using the ORSZ to treat the children’s diarrhoea and were provided with pictorial+written instruction sheets. Survey staff recorded diarrhoea treatment behaviours pre- and post-intervention to enable estimation of change in ORSZ treatment rates.
Pilot Outcomes
We observed an increase in the usage rates of 42.0 - 52.8 pp in ORS use and 61.5 - 83.0 pp for ORSZ across 4 wards (sub-geographies). This was a larger-than-expected change which is promising but needs to be interpreted carefully given several limitations in our pilots (see below). We also measured the ‘diversion’ of our ORS sachets to older age groups > 5 years old to understand the proportion of our products that would be available for our intended users. Across the wards, the diversion rate ranged from 13-21%. This doesn’t qualitatively change our view of the potential for the intervention, but more needs to be done to understand the accuracy and impact of this figure.
Though these results are very promising, we treat the apparent effect size with caution. For example, social desirability bias may inflate self-reported ORSZ usage rates, the pilot had partial (6.5% of households) overlap with a nutrition program that provided ORS, and our data collection does not fulfil all of the assumptions of the statistical methods used. We strive to improve upon all of these limitations in our next operational round. For more details on our limitations, please refer to our full report.
What's Next?
We plan to balance scale-up and building upon the learnings to date with operational variants aimed at improving the core intervention. Near-term, we aim for the next major round of operations May-June’24, with up to 3x pilot scale (~16,000-20,000 children under-5) and a subset of the more significant operational variants we elaborate in the report “Next Steps”.
Commenti